Normative EMG Values during REM Sleep for the Diagnosis of REM Sleep Behavior Disorder

作者：Birgit Frauscher, Álex Iranzo, Carles Gaig, Viola Gschliesser, Marc Guaita, Verena Raffelseder, Laura Ehrmann, Núria Solà‐Valls, Manel Salamero, Eduardo Tolosa, Werner Poewe, Joan Santamaría, Birgit Högl · 发表于：SLEEP · 年份：2012 · DOI：10.5665/sleep.1886 · 被引用次数：415 · 研究领域：Restless Legs Syndrome Research、Obstructive Sleep Apnea Research、Sleep and related disorders

BACKGROUND: Correct diagnosis of rapid eye movement sleep behavior disorder (RBD) is important because it can be the first manifestation of a neurodegenerative disease, it may lead to serious injury, and it is a well-treatable disorder. We evaluated the electromyographic (EMG) activity in the Sleep Innsbruck Barcelona (SINBAR) montage (mentalis, flexor digitorum superficialis, extensor digitorum brevis) and other muscles to obtain normative values for the correct diagnosis of RBD for clinical practice. SETTING: Two university hospital sleep disorder centers. PARTICIPANTS: Thirty RBD patients (15 idiopathic [iRBD], 15 with Parkinson disease [PD]) and 30 matched controls recruited from patients with effectively treated sleep related breathing disorders. INTERVENTIONS: Not applicable. METHODS AND RESULTS: Participants underwent video-polysomnography, including registration of 11 body muscles. Tonic, phasic, and "any" (any type of EMG activity, irrespective of whether it consisted of tonic, phasic or a combination of both) EMG activity was blindly quantified for each muscle. When choosing a specificity of 100%, the 3-sec miniepoch cutoff for a diagnosis of RBD was 18% for "any" EMG activity in the mentalis muscle (area under the curve [AUC] 0.990). Discriminative power was higher in upper limb (100% specificity, AUC 0.987-9.997) than in lower limb muscles (100% specificity, AUC 0.813-0.852). The combination of "any" EMG activity in the mentalis muscle with both phasic flexor digi...